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The growing interest to quality improvement in Health care has been motivated by several constitutions:
1/ The difference in clinical practice between health care providers. For the same clinical symptoms reported by the patient we can note a variation in decision making. Therefore, the development of good practice guidelines, might help to reduce such variations. Currently, there has been a rising interest to evidence based medicine.

2/ The presence of inappropriate care remains common, for example nosocomial infections, medical errors. The process analysis help to improve care reliability in each step and to better understanding problems.

3/ Patient (consumer) expectative has been evaluated, the consumers is more demanding and require more information about his disease, biological exams and treatments. He also requires a better environmental conditions…

4/ In general, we note that is an important development in the health care offer. Therefore, to avoid absolute and non rational health care resources use it is crucial to consider quality as a core principle behind the performance institution.

5/ As a consequence from the latter point, there has been an important competition amongst health structures.

6/ From an economic point of view, many studies have found that quality costs less than non quality.